June 01, 2013

PESHAWAR: After an intensified security plan has been chalked out for protection of teams, the authorities on Friday decided to resume the anti-polio campaign in Peshawar and other parts of Khyber Pakhtunkhwa on June 10.

The security plan was finalised at a high-level meeting of the security and Health Department officials with Peshawar Commissioner Sahibzada Mohammad Anis in the chair.

At least 700,000 children under five years of age will be administered drops by the volunteers of 2000 teams that will be properly guarded by the police. Sahibzada Mohammad Anis said the volunteers would be provided adequate security during the campaign.

The anti-polio vaccination campaign was suspended on May 28 after a female volunteer Sharafata, 18, was killed and another volunteer, Sumbul, 20, was wounded when armed men attacked the team in Kaga Wala village on the outskirts of Peshawar. Sumbul is still being treated at the Lady Reading Hospital since she suffered two bullet wounds on her upper body.

The women were not being guarded by the police as promised by the government after a number of attacks on anti-polio vaccination teams during the last couple of months. The local police said the volunteers in the area had refused police security, saying it can cause more threat to the teams.

After the attack, the police launched a search operation in the area, during which 14 suspects were rounded up. A police sub-inspector Salim Khan suffered heart attack during the search operation and died.

District Coordination Officer (DCO) Najam Ahmad Shah on Saturday said the spread of measles in the district was due to negligence on the part of the Health Department staff.

He was visiting the measles ward at Divisional Headquarters Hospital here on Saturday.

He said, “The health department officers and officials should work honestly for the eradication of measles. Else, strict action would be taken against them.” Shah said the disease had spread rapidly due to the delinquency of the health staff.

He said, “Arrangements should also be made to deal with gastroenteritis, cholera and other seasonal diseases.”

The hospital medical superintendent Dr Muhammad Arif Ali told The Express Tribune that separate wards had been set up at the hospital for measles and other seasonal diseases.

He said, “As many as 470 measles patients had so far been treated and discharged from the hospital… 17 children suffering from measles are still admitted in the hospital where they are being well looked after.”

Ali said additional medical and paramedical staff had been deputed in the measles ward. He said emergency situations could also be handled as there was no shortage of medicines.

It's about 3:00 on Sunday morning in Florence, and the Italian media don't have anything new to add to what's posted below. The story has moved attention away from Saudi Arabia, which has said nothing about its own cases since the Arab News piece yesterday complaining about the lack of transparency. The Jordanians have mentioned the Italian cases, if only because two of the three patients are a Jordanian expatriate and his granddaughter.

The latest cases certainly reflect today's globalized world, where the country you work in may not be the country you grew up in, and where the spread of a disease is constrained chiefly by airline schedules. Italy's index case is also notable because he works in a Florence hotel, where he returned to work and promptly infected a co-worker. This is the kind of event that gives "presenteeism" a bad name.

It's also the kind of event that must send a shudder through every country's tourism industry. SARS spanned the world from a chance gathering of Hong Kong hotel guests waiting for their elevator, one of them being a desperately ill doctor from Guangdong. We can safely assume that all staff in the index patient's hotel are under observation this weekend.

WHO's latest post, already overtaken by events, appeared earlier today. We can safely assume that staff at WHO in Geneva and ECDC in Stockholm have been working hard this weekend, and more official updates will appear sometime Sunday, or very early Monday.

That's hard on the staff, who deserve our heartfelt thanks. But it's also reflective of how quickly the world's online immune system responds to a threat. Information goes out within minutes of being announced, and millions of people respond: travellers, health experts, politicians. The economic impact of H7N9 on China was (and is) enormous. The impact of MERS, from the Hajj to the market for summer villas in Tuscany, is likely to be comparable, regardless of how many eventually fall ill from it.

No new cases of the SARS-like coronavirus have been registered in the Kingdom for more than 13 months, but the Ministry of Health is monitoring any suspected case, an official said on Saturday.

Mohammad Abdullat, director of the Health Ministry’s communicable diseases directorate, said since April 2012, “we have not reported any case of the virus, but we have to stay alert, and we are following up on some suspected cases”.

Two people infected with the virus died in Jordan in 2012, and it took health authorities several months to determine its type.

However, Abdullat noted that a team from the US Centres for Disease Control and Prevention recently came to Jordan to investigate the spread of the virus and took samples to test them in the United States.

The samples, he explained, were taken from health workers who had the symptoms of coronavirus and “we will be informed of the results soon”.

The coronavirus shares some of the symptoms of SARS, or Severe Acute Respiratory Syndrome, which emerged in China in 2002, spread easily among people and killed around a tenth of the 8,000 it infected worldwide.

The coronavirus can appear to be pneumonia, and acute kidney failure has occurred in five cases, according to the World Health Organisation (WHO).

Meanwhile, Italy reported its first case of the SARS-like coronavirus on Friday, a 45-year-old man who had been travelling in Jordan, Reuters reported, quoting the Italian health ministry.

The patient was in good condition and was being monitored in isolation, according to Reuters.

He was admitted to a hospital in Tuscany with a high fever, a cough and breathing difficulties.

“A resident of Italy with foreign nationality, the man recently spent 40 days in Jordan where one of his sons was suffering from an unspecified flu,” Reuters said in a report published on Friday.

Meanwhile, the Ministry of Health on Saturday discussed the case with the WHO’s representative in Amman, Akram Ali Eltom, according to the Jordan News Agency, Petra.

The ministry’s internal department specialised in the coronavirus launched a series of investigations into the matter, Petra reported.

A quick check of Jordan's Arabic media turned up on this one story, which is much more superficial, and dated compared to the Jordan Times story.

• It is two people who have had close contact with the first case, and both are in good health.

• Ministry is closely monitoring the situation.

The Region of Tuscany in the late afternoon announced today that the Ministry of Health two subjects already under medical surveillance because it entered into close contact with the first case of infection with Italian MERS CoV, have developed a clinical form of respiratory infection, which at the time presents a framework for both non-serious.

Laboratory investigations, carried out in collaboration between health authorities of Tuscany and the National Institute of Health, confirmed the diagnosis of infection with MERS CoV.

The two new cases refer to a child of about two years, part of the family of the first patient, and a co-worker of the same.

Both patients are hospitalized in isolation at health facilities in Florence.

The transmission of infection from diseased to people who have had prolonged close contact with them has already been documented, even in Europe, in the home and hospital.

The Ministry of Health is closely monitoring the situation in close contact with the health authorities of Tuscany.

Rises to three new cases of SARS. One is the granddaughter of a few months and the other a colleague of the Jordanian patient admitted to the hospital on Tuesday in Florence. Both subjects were under medical surveillance because they came into close contact with the man suffering from Mers. This is confirmed by the ministry. This brings to three cases.

One is the granddaughter of the Jordanian patient of 45 years who was admitted to Careggi Hospital in Florence on Tuesday. The child of a year and a half has been admitted to the Meyer pediatric center and is in isolation. In the evening came the results of tests that confirmed the presence of the virus Mers, then the contagion. The tests will be repeated also by the National Institute of Health for final confirmation.

The girl had symptoms of the disease: cough, and fever. She would have been in contact with her grandfather on Sunday; then Monday the man went to work, returning in the evening. The next morning he went into the hospital.

The other is an infected colleague: a Jordanian citizen working in a hotel in Florence. Control for contacts with the first patient with Mers there are 43 people, a number that is growing, however. Among these, the brother of the man, in addition to health that have treated these days.

The ministry is working to warn the passengers who traveled with him from Amman to Vienna, from Vienna to Bologna and from Bologna to Florence. The checks cover travelers who were in the same row or two in front and behind.

Update: Meanwhile, broadcaster RAI reports that the condition of the two new patients "is not serious," and has "a low risk of contagiousness person to person." La Stampa has the basic details in an Italian-language Reuters report but tells us the co-worker is a 40-year-old Italian woman, not a Jordanian. This is why I am not a fan of computer translation.

Two new cases of coronavirus, also known as New Sars, Italy. The news was confirmed by the Ministry of Health.

"The Tuscany region-according to a ministry statement-announced late in the afternoon that two subjects, already under medical surveillance because it entered into close contact with the first case of infection with Italian MERS CoV, have developed a clinical form of respiratory infection, which currently presents a framework for both non-serious "

Being always the same note: "Laboratory tests, conducted in collaboration between health authorities of Tuscany and the National Institute of Health, confirmed the diagnosis of infection with MERS CoV. The two new cases-is-specified refer to a child of about two years, part of the family of the first patient, and a co-worker of the same. Both patients are hospitalized in isolation at health facilities in Florence."

The Ministry of Health follows "closely monitoring the situation in close contact with the health authorities of Tuscany."

So after returning from Jordan, the 45-year-old man appears to have spread the virus to a fellow-worker as well as his granddaughter. So far, at least, no healthcare workers seem to have shown any symptoms.

Meanwhile, WHO has released a June 1 Disaster Outbreak News item that doesn't include these new cases but otherwise provides a good summary of the situation.

After the discovery of the first case of SARS in Italy, Florence is triggered immediately checks. A little girl of 1 year and a half is hospitalized at the pediatric hospital of Florence Meyer pending the outcome of the tests. She is the granddaughter of the Jordanian who was hospitalized yesterday at Careggi and who had been diagnosed Coronavirus.

The child is not sick but have a cough. Unlike the first such information during a press conference at Careggi, the child is not of school age. Tonight there will be the results of the inspection.

Control for contacts with the Jordanian citizen who has long lived in Florence, there are 43 people, including the brother of the man, in addition to health that have treated these days. 43 people are also counted in the 10 colleagues who work with him in a hotel in Florence.

So it's now confirmed that the man is a Jordanian expatriate, with several family members also living in Florence. The story goes on to say the man was showing the first symptoms on his return flight from Jordan, flying Amman-Vienna-Bologna; he stayed home one day and then went back to work at the hotel. On Tuesday he went to the hospital.

An outbreak of an infectious virus that can cause polio-like paralysis is concerning health officials.

The same virus, a strain of enterovirus 71 (EV71), has led to hundreds of deaths in China.

Five children, including one in Victoria, have suffered from a polio-like paralysis this year because of a severe complication from the strain, known as C4a. Dr Bruce Thorley, of the Victorian Infectious Diseases Reference Laboratory, said the strain had been circulating in Asia for some time but was only now being detected in Australia.

Strains of EV71 that usually circulate here cause milder symptoms such as rashes, fever and blisters on the hands, feet and mouth (commonly known as hand-foot-and-mouth disease, or HFMD). But the C4a strain could, in rare cases, cause severe neurological complications such as inflammation of the brain -meningitis and encephalitis - and paralysis, Dr Thorley said.

In NSW, 27 children who were admitted to hospital with meningitis or encephalitis in the month to May 12 had an EV71 infection.

Dr Thorley cautioned that strains of EV71 often circulated in the population and most infections caused no noticeable symptoms in adults or children.

"But now, to have such a number of positive detections including paralysis, I would regard it as an outbreak," he said.

He said four of the cases of paralysis were in NSW and one in Victoria, with investigation of all cases of paralysis in children being co-ordinated in collaboration with the Australian Paediatric Surveillance Unit.